Abstract: OBJECTIVE To explore the epidemiological characteristics and risk factors for health care-associated infections (HAIs) with carbapenem-resistant Enterobacteriaceae (CRE) among the hospitalized patients of surgery department so as to provide bases for reasonable clinical use of drugs, prevention and control of the infections. METHODS By means of a 1∶1 ratio of case-control study, the patients who had HAIs with CRE and were hospitalized in surgery department of Taihe Hospital Affiliated to Hubei University of Medicine from Jan. 2014 to Dec. 2024 were enrolled in the study and were assigned as the case group. The patients with non-CRE infections were chosen as the control group by matching with the sex, hospitalization department, age, and underlying diseases. The data including demographic characteristics, underlying diseases, length of hospital stay, invasive procedures and exposure to antibiotics were collected from the two groups of patients. The risk factors for the CRE infections were observed. RESULTS A total of 118 pairs of CRE infection patients and matched controlled patients were enrolled in the study. The CRE infections were more common in neurosurgery department, orthopedics department and cardiothoracic surgery department. Klebsiella pneumoniae was the predominant species of pathogen and was highly resistant to cephalosporins and fluoroquinolones (with the drug resistance rates more than 70%), and it maintained high susceptibility to tigecycline and polymyxin B. The incidence of hypoproteinemia, length of hospital stay, proportion of patients treated with invasive procedures and utilization rate of broad-spectrum antibiotics were higher in the case group than in the control group (P＜0.05). Multivariate logistic regression analysis showed that puncture(OR=5.647,95%CI:1.687 to 21.275), use of human albumin(OR=3.465,95%CI:1.078 to 11.765) and exposure to penicillins(OR=5.281,95%CI:1.754 to 17.368) were independent risk factors for the HAIs with CRE. CONCLUSION The HAIs with CRE in the hospitalized patients of surgery department are closely associated with the puncture, use of human albumin and exposure to penicillins.